Abstract
Regardless of never ending discussions related to the suprasyndesmal screw, attention has to be paid particularly to anatomical reduction of the fibula into the fibular notch of the tibia. This implies the following:
1. In high C type fractures and in all B and C type fractures with avulsion of the posterior wall of the tibia, it is preferable to obtain preoperative CT.
2. After completion of internal fixation of B and C type fractures it is always necessary to check intraoperatively stability of the mortise in the mediolateral and anteroposterior direction.
3. It is always necessary to follow the proper surgical technique of insertion of the suprasyndesmal screw, i.e. anatomical reduction of fibula into the notch, temporary fixation by a K-wire, insertion of vymezovaciho(??) screw 2 to 3cm proximal to the joint line, and only then remove the K-wire.
4. If suprasyndesmal screw is used for the treatment, it is always recommended to obtain postoperative CT.
5. Based on a number of CT studies, closed reduction of the fibula into the tibial notch has to be rejected and reduction must be performed always under visual control.